福建省部分地区乙型肝炎病毒基因型分布及其临床意义

胡盈莹; 江家骥; 欧文湖; 林国贤; 苏智军; 刘家俊; 李勤光; 姚履枫; 林彩文; 李丹; 陈怡

Abstract

胡盈莹,江家骥,欧文湖,林国贤,苏智军,刘家俊,李勤光,姚履枫,林彩文,李丹,陈怡.福建省部分地区乙型肝炎病毒基因型分布及其临床意义[J].Chinese journal of Epidemiology,2004,25(3):251-255

福建省部分地区乙型肝炎病毒基因型分布及其临床意义

Distribution of hepatitis B virus genotype in 5 cities of Fujian province and the clinical implications of HBV genotype

Received:October 12, 2003

DOI：

KeyWord: 乙型肝炎病毒基因型聚合酶链反应-限制性片段长度多态性 logistic回归分析对应分析

English Key Word: Hepatitis B virus Genotype Polymerase chain reaction-restriction fragment length polymorphism Logistic regression Correspondence analysis

FundProject:

Author Name	Affiliation	E-mail
HU Ying-ying	Municipal Hospital of Infection, Fuzhou 350025, China
JIANGJia-ji	Municipal Hospital of Infection, Fuzhou 350025, China	ying_hyy@21cn.com
OU Wen-hu	Municipal Hospital of Infection, Fuzhou 350025, China
LIN Guo-xian	Municipal Hospital of Infection, Fuzhou 350025, China
SU Zhi-jun	Municipal Hospital of Infection, Fuzhou 350025, China
LIU Jia-jun	Municipal Hospital of Infection, Fuzhou 350025, China
LI Qin-guang	Municipal Hospital of Infection, Fuzhou 350025, China
YAO Lv-feng	三明市第一医院
LIN Cai-wen	莆田市第二医院
LI Dan	泉州市第一医院
CHEN Yi	厦门市中医院

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Abstract:

目的<\b> 首次调查福建省5个地区乙型肝炎病毒(HBV)基因型的分布状况,并探讨HBV基因型与HBV相关肝病临床的可能相关性。方法<\b> 收集福州市、厦门市、泉州市、三明市、莆田市等地区慢性HBV感染者的血清,采用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)法检测HBV基因型,应用多因素logistic回归分析、对应分析研究HBV基因型与临床的相关性。结果<\b> 431例HBV DNA阳性血清中基因B型275例(63.8％)C型100例(23.2％),D型及其混合型共51例(11.8％),未见A、E、F型。多因素logistic回归分析显示,泉州和三明地区HBV基因B型所占比例显著高于福州地区(P=0.002;P=0.006);无症状携带者、慢性肝炎、重型肝炎组都是以基因B型为主要基因型;基因C型在肝硬化中所占比例(47.0％)显著高于无症状携带者(14.5％)和重型肝炎组(14.7％)(P=0.009;P<0.001);基因B型的e抗原阳性率(52.4％)显著低于C型(56.0％)(P=0.008);基因D型患者e抗原阳性率(30.8％)也低于C型(P=0.051)。对应分析表明原发性肝癌(HCC)与基因D型及其混合型关系密切。结论<\b> (1)福建省HBV感染以基因B型为主,其次是C型,也存在基因D型的流行。(2)福建省部分地区基因型B和C的分布可能存在差异。(3)基因B型在年轻患者中可能与重型肝炎的发展有关;基因C型在年长患者中可能更易导致肝?

English Abstract:

Objective<\b> To study the prevalence of hepatitis B virus(HBV) genotype in 5 cities of Fujian province and the clinical implications of distinct genotypes in HBV--related liver diseases. Methods<\b> HBV genotype was determined by the restriction fragment length polymorphism analysis in patients with chronic HBV infection in 5 cities of Fujian province. The relationship between HBV genotype and its clinical implications was studied by multinomal logstic regression and correspondence analysis. Results<\b> Of the 431 HBV DNA positive patients detected by PCR, 275 (63. 8%) belonged to HBV genotype B, 100(23. 2%) to genotype C, 51 (11. 8%) to genotype D and D--mixed genotype. Genotype A, E and F were not found. Multinomal logistic regression showed that genotype B was more prevalent in Quanzhou and Sanming cities than in Fuzhou (P = 0. 002, P = 0. 006), and genotype B appeared significantly more common in asymptomatic carriers (ASC), chronic hepatitis B (CHB) and severe hepatitis (SH). Genotype C was most prevalent in patients with liver cirrhosis (LC) (47. 0%) than in those with ASC(14. 5%) and SH(14. 7%) (P = 0. 009, P 0. 001). The positive rate of hepatitis B e antigen was higher in patients with genotype C than in those with genotype B and genotype D (56. 0% vs. 52. 4 %, P = 0. 008, and 56. 0% vs. 30. 8%, P = 0. 051, respectively). By correspondence analysis, genotype D and D--mixed genotype seemed to be correlated with hepatocellular carcinoma (HCC). Conclusion<\b>s (1 The major popular genotypes of HBV were B, C and D in Fujian. (2) Data of our study suggested that the geographic distribution of genotype B and C might be different in some cities of Fujian. (3) Genotype B might have a tendency to lead to SH in younger patients with chronic hepatitis B and the development of LC might be associated with genotype C among the elder patients. (4) Genotype D appeared to associate with development of HCC, which called for further study to confirm.

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